DESCRIPTION: (Applicant's Description) The over all goal of the proposed research is to develop, implement and evaluate a problem solving therapy-based home care training program for younger women with breast cancer (less than 50 years of age) who are receiving chemotherapy and their primary caregivers. This proposal describes a two phase research effort to first, design an intervention informed by the experience of younger women and their families who have completed a course of chemotherapy treatment for breast cancer, and second, to implement the intervention and evaluate its effectiveness in reducing psychosocial morbidity and enhancing the quality of life among younger women with breast cancer. Newly diagnosed women will be recruited and randomized to experimental and control conditions in two geographic sites: Rhode Island (state-wide oncology practices), and Hahnemann Medical Center in Philadelphia, Pa. Specifically, this research will address the following aims: 1)To characterize the specific medical, psychological and practical needs of younger women recently diagnosed with breast cancer who are receiving chemotherapy; 2) to describe the impact of the diagnosis and treatment of breast cancer in younger women on the role adjustments and emotional distress levels of their caregivers; 3)based on Phase 1 data, to refine and implement a practical,cost-effective intervention which will train the patient/principal caregiver dyad in problem-solving techniques designed to meet the medical, psychosocial and practical needs of younger women with breast cancer on chemotherapy; 4) to test the effect of the intervention on the patients' symptom experience, levels of emotional distress, unmet practical needs and adjustments to changes in their roles both at home and at work; 5) to test the effect of the intervention on caregivers' levels of emotional distress, sense of competency in caregiving tasks, and adaptation to the caregiving role as they seek to meet the needs of younger women with breast cancer who are receiving chemotherapy;6) to test the effect of the intervention on marital versus non-marital patient/caregiver dyads, including its mediating effect on the impact of the cancer experience on the quality of the patient/caregiver relationship. Further, to test the effects of the intervention on patient/caregiver dyads compared with women who participate in the intervention without a self-designated support person.